title: Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria.
abstract: OBJECTIVE
  To develop a new national screening guideline for retinopathy of prematurity (ROP).
  
  
  METHODS
  Included were infants of the 2009 prospective ROP inventory in The Netherlands with gestational age (GA) <32 weeks and/or birth weight (BW) <1500 g. Five models were studied, based on GA and BW in combination with no, one or a set of five risk factors for ROP. Risk factors were determined by logistic regression. In MEDLINE and EMBASE, additional risk factors were searched. A precondition was that no infants with severe ROP would be missed. Receiver operating characteristic curves or classical measures were used to determine diagnostic accuracy.
  
  
  RESULTS
  The model including all infants with severe ROP comprised screening of infants with GA <30 weeks and/or BW <1250 g and a selection of infants with GA 30-32 weeks and/or BW 1250-1500 g, with at least one of the following risk factors: artificial ventilation (AV), sepsis, necrotising enterocolitis (NEC), postnatal glucocorticoids or cardiotonica. This model would not detect 4.8% (95% CI 2.5% to 8.0%) of infants with mild ROP and would reduce infants eligible for screening by 29%.
  
  
  CONCLUSIONS
  In The Netherlands, screening may be safely reduced using a new guideline based on GA, BW, AV, sepsis, NEC, postnatal glucocorticoids and cardiotonica.
authors.affiliation: Department of Ophthalmology, Leiden University Medical Centre, The Netherlands. a.j.van_sorge@lumc.nl
authors.forename: A J
authors.initials: AJ
authors.lastname: van Sorge
authors.forename: N E
authors.initials: NE
authors.lastname: Schalij-Delfos
authors.forename: F T
authors.initials: FT
authors.lastname: Kerkhoff
authors.forename: L J
authors.initials: LJ
authors.lastname: van Rijn
authors.forename: J L A M
authors.initials: JL
authors.lastname: van Hillegersberg
authors.forename: I L A
authors.initials: IL
authors.lastname: van Liempt
authors.forename: P G M
authors.initials: PG
authors.lastname: Peer
authors.forename: H J
authors.initials: HJ
authors.lastname: Simonsz
authors.forename: J U M
authors.initials: JU
authors.lastname: Termote
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000458:organization & administration; D015997:Neonatal Screening / Q000379:methods; D009426:Netherlands / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000453:epidemiology; D012307:Risk Factors
keywords: Child health (paediatrics); Retina